Harrell, StevanLuo, Juan2026-04-202026-04-202026Luo_washington_0250E_29077.pdfhttps://hdl.handle.net/1773/55435Thesis (Ph.D.)--University of Washington, 2026My ethnography focuses on Health Equity Alliance (HEA), an international charity organization providing health and humanitarian assistance in the border areas of Myanmar’s Kachin and Shan States neighboring China’s Yunnan Province. My research explores three dimensions of HEA’s entanglements with both government and self-governance actors in facilitating the health services network, which can be defined as legitimacy, sensitivity, and adaptability. By studying HEA’s entanglements and its resilience to changing environments, I propose the concept of “excluded middle” to describe INGOs that operate on the ground, collaborating with local actors and building local capacities, but have not yet been fully recognized and discussed in NGO studies and within the aid sector. This type of INGOs like HEA occupies a middle ground between the simplified dichotomy of top-down large INGOs and subordinate local NGOs in the first place and transforms into a decentralized INGO at the national level that is neither fully local nor entirely international in the second place. In doing so, I aim to challenge the prevailing dichotomies between INGOs, Western NGOs or global NGOs, and national, local, grassroots NGOs, found in both critical anthropology of development and in humanitarian and development aid sectors shaped by the Global North versus Global South framework. Through a historically grounded organizational ethnography of HEA, I argue that INGOs are not a fixed category but can be dynamic organizations capable of doing good by innovating cross-border health aid models and strengthening public health systems, as well as shifting power and resources to local actors through decentralized approaches.application/pdfen-USnoneCultural anthropologyAnthropologyThesis